It is well documented that physical activity has many positive effects on health (reference). In general, people who are physically active have a higher quality of life and are at a reduced risk of developing many chronic diseases (such as arthritis, cancer, diabetes, heart disease, respiratory illnesses) compared to individuals who are sedentary.

A question that now arises, is does physical activity have a greater effect on health compared to medications? A recent journal article in BMJ (published on October 1st, 2013) looked to address this question.

What did the researchers do?
To determine if physical activity had a greater impact on health compared to taking medications, the researchers pooled the results of 16 separate meta-analyses (four of which were on exercise and 12 on medications), where a meta-analysis is a statistical method of combining the results of similar studies to increase the number of participants who received an intervention. Health was examined by determining mortality rates associated with 4 diseases:

  • Coronary heart disease
  • Diabetes
  • Stroke
  • Heart failure

What did they find?

  • Coronary heart disease: Physical activity and medications were equally effective in reducing mortality.
  • Diabetes: Physical activity and medications were equally ineffective in reducing mortality.
  • Stroke: Physical activity was more effective than medications for reducing mortality risk.
  • Heart failure: Certain medications (diuretics) were superior to physical activity in reducing occurrences of heart failure.

Are there limitations to this study?
Yes, unfortunately there were a number of limitations to this study, making it difficult to reach a definitive conclusion.

  • There are a limited number of randomized clinical trials (RCT) looking at the effectiveness of exercise/physical activity on mortality. The majority of studies looking at the health effects of physical activity are observational, which are not as strong in predicting cause and effect as an RCT
  • The authors correctly commented that they had relied on information from previously completed meta-analyses, and that several larger RCTs had been completed but were not “pooled” in with their data. It is possible that these new RCTs could have affected the results.
  • It is unclear if the appropriate amount/type of physical activity was chosen in the original studies to reach a conclusion. This is important issue as some studies underestimate the amount of activity required to reach a desired outcome. An example of this would be how much exercise is required to lose weight? If a study has selected 30 minutes as the amount of time one is required to exercise in order to lose weight, it might be insufficient (more time might be required). As well, the study may not account for what an individual is doing for the remainder of the day with regards to being physically active. So, if a person is exercising 30 minutes per day, and he/she is sedentary for the rest of the day, the 30 minutes spent exercising would be insufficient to have an impact on weight loss or on other possible health outcomes.
  • In addition to the above point, while it is known what direct effect a medication has on an outcome (e.g. dose x will result in x% decrease of blood pressure), the same is not always known for exercise (e.g. how much and what type of exercise should be done to achieve a certain outcome, etc).

What is the take home message?
The take home message is that physical activity has equivalent or better outcomes in the treatment of certain health conditions. Specifically, being physically active will reduce the mortality risk of coronary heart disease, diabetes, and stroke. Does this mean that if you suffer from certain conditions you should stop using your prescribed medications? Absolutely not. The findings from this article reinforce the fact that physical activity is vital to health, and being physically active can reduce one’s risk of mortality from certain diseases.

If you suffer from a chronic disease, or if you are at risk of developing a chronic disease, can physical activity help you? Yes. But before starting on a new exercise routine, talk to your health care provider about what type of activity is both safe and effective for you.

In practice, I council my patients on increasing their level of physical activity, taking into account their health condition(s), possible medications and level of physical fitness. If you have questions about a chronic health concern, physical activity or how Naturopathic Medicine can help you, please give me a call at 613-290-6115.